CT三维重建联合胸腔镜精准肺段切除术对早期肺腺癌近期结果的影响分析

Effect of CT 3D reconstruction combined with thoracoscopic precision segmentectomy on the short-term outcome of early lung adenocarcinoma

目的 探讨CT三维重建联合胸腔镜精准肺段切除术对早期肺腺癌近期结果的影响。方法 回顾性分析2020年1—12月间在惠州市中心人民医院接受肺段切除术治疗的早期肺腺癌病人100例的临床资料,根据手术方式的不同分为接受CT三维重建联合胸腔镜精准肺段切除术治疗的精准治疗组(n=41)、接受传统胸腔镜肺段切除手术治疗的传统治疗组(n=59),对比其手术情况相关指标、肺功能参数值、术后并发症发生情况、术后1年复发情况的差异。结果 精准治疗组病人的手术时间(102.31±19.38)min短于传统治疗组(118.64±21.23)min,术中出血量(62.45±8.34)mL少于传统治疗组(77.23±10.21)mL,差异有统计学意义(P<0.05)。精准治疗组、传统治疗组病人的淋巴结清扫个数差异无统计学意义(P>0.05)。术后1个月,精准治疗组病人的用力肺活量(FVC)(3.40±0.56)L、第1秒用力呼气容积(FEV1)(2.31±0.40)L、肺一氧化碳弥散量(DLCO)(17.95±2.68)mL·mmHg-1·min-1水平分别高于传统治疗组的(2.86±0.41)L、(2.08±0.36)L、(14.53±2.10)mL·mmHg-1·min-1,差异有统计学意义(P<0.05)。术后3个月,精准治疗组、传统治疗组病人的FVC、FEV1、DLCO水平差异无统计学意义(P>0.05)。精准治疗组、传统治疗组病人的术后并发症发生率差异无统计学意义(P>0.05)。术后随访1年内,两组病人均未发现复发病例。结论 CT三维重建联合胸腔镜精准肺段切除术可优化手术过程、改善早期肺腺癌病人术后早期的肺功能,可能是一种更为精准可靠的手术模式。

Objective To investigate the effect of CT 3D reconstruction combined with thoracoscopic precision segmentectomy on the short-term outcome of early lung adenocarcinoma.Methods A retrospective analysis was performed on the clinical data of 100 patients with early stage lung adenocarcinoma who received segmental pulmonary resection in Huizhou Central People's Hospital from January 2020 to December 2020.According to the different surgical procedure,the patients were assigned into accepting CT 3D reconstruction precision combined thoracoscope lung segment resection treatment of the precision of the treatment group(n=41),traditional thoracoscope lung resection surgery treatment of traditional treatment group(n=59).The differences in the related parameters of operation condition,lung function parameter values,postoperative complications,and 1 year recurrence after operation were compared.Results The operative time of patients in the precision treatment group(102.31±19.38) min was shorter than that in the traditional treatment group(118.64±21.23) min,and the intraoperative blood loss(62.45±8.34) mL was less than that in the traditional treatment group(77.23±10.21) mL,with statistical significance(P<0.05).There was no significant difference in the number of lymph node dissection between the precision treatment group and the traditional treatment group(P>0.05).One month after surgery,the levels of forced vital capacity(FVC)(3.40±0.56) L,forced expiratory volume in one second(FEV1)(2.31±0.40) L and carbon monoxide diffusion capacity(DLCO)(17.95±2.68) mL·mmHg-1·min-1 in the precision treatment group were higher than those in the traditional treatment group [FVC(2.86±0.41) L,FEV1(2.08±0.36) L and DLCO(14.53±2.10) mL·mmHg-1·min-1],with statistical significance(P<0.05).At three months after surgery,there were no significant differences in FVC,FEV1 and DLCO levels between the precision treatment group and the traditional treatment group(P>0.05).There was no significant difference in the incidence of postoperative complications between the precision treatment group and the traditional treatment group(P>0.05).No recurrence was found in both groups within 1 year of postoperative follow-up.Conclusion 3D CT reconstruction combined with thoracoscopic precision segmental pulmonary resection can optimize the surgical process and improve the early postoperative lung function of patients with early lung adenocarcinoma,which may be a more accurate and reliable surgical mode.